She's quite the social butterfly, but Lynn Stockmaster says that when seasonal allergies strike, time with her husband and friends, and even her dog, is sometimes usurped by a soft couch, a bottle of Benadryl and a box of tissues.

"Being congested all the time makes me feel more tired and grumpy," says Stockmaster, 43, a telecommunications project manager from Rochester, N.Y. "Lack of oxygen? Breathing through my mouth? It's just kind of unattractive and irritating. I am definitely less social when allergies flare up."

As the dawn of spring allergy season arrives in much of the country this month, the 40 million Americans who have seasonal allergies — sensitivity to tree, flower and other plant pollens — will be sneezing and congested and fending off sinus headaches and red eyes for weeks to come.

But a number of them also will endure a host of other less concrete symptoms, including irritability, mood changes, fatigue and even depression. In recent years, allergists have begun working with psychologists to better understand why the "allergy blues" occur, and the answer — immune system proteins or just a lack of sleep, or possibly a combination of the two — is still up for debate.

A mind-body link?

Over the past decade, a flurry of research has suggested allergic reactions cause feelings of fatigue and depression because of the release of proinflammatory cytokines, proteins released by immune cells rushing to protect an allergic person from pollen or other allergens that have entered the body, says Paul Marshall, a clinical neuropsychologist in the department of psychiatry at Hennepin County Medical Center in Minneapolis.

"It's thought that those cytokines directly affect the central nervous system, causing the release of a chemical in the brain called IL-1 beta that induces sickness behavior, such as weakness, lethargy, low mood and the inability to concentrate," Marshall says.

He says research strongly indicates that having allergies increases the likelihood of having depression twofold. "I wonder sometimes how many allergists really are aware of that."

In a study published in Psychosomatic Medicine in 2002, Marshall collaborated with allergist colleague Paul Steinberg and followed patients allergic to ragweed for a year from one allergy season, through winter when pollen counts drop and again during the following year's ragweed season.

"We saw … that behaviors associated with positive mood — enthusiasm, attentiveness, alertness — went down during ragweed season, then up during winter, then back down during the following ragweed season," Marshall says.

Another factor could be at play, too, says Bruce Bender, head of the division of pediatric behavioral health at the National Jewish Medical and Research Center in Denver.

"There's an emerging body of research showing that one of the mechanisms at work here is people with allergies sleep poorly," Bender says. He will present a lecture on the topic at this month's meeting of the American Academy of Allergy Asthma & Immunology in Philadelphia. "Poor concentration and mood in seasonal allergy patients may be a secondary effect of a very poor night's sleep."

Sleep affects mood

Ben Medrano, 30, a biology pre-med major at the University of Colorado-Denver who has had seasonal allergies since childhood, says he's plagued by congestion and insomnia from May through September every year.

"During allergy season … I get anywhere from three to six hours of sleep on average at night. That's almost half my year," says Medrano, who relies on sleep medication sometimes.

A study in the Archives of Internal Medicine in 2006 showed that people with allergic rhinitis were more likely to have sleep problems than people without the condition. In the study, about 35% of allergic rhinitis patients reported insomnia.

Bender and his colleagues are planning a study in which they will hook up seasonal allergy patients to an actigraph, a wrist-worn device donned during sleep that senses wakefulness. It tells researchers what percentage of time the patients are actually sleeping.

There isn't a clear and obvious solution to improving sleep, and therefore mood, in allergy patients, Bender says.

"Many people think that they can treat themselves," he says. "But if they have chronic symptoms every year during allergy season, they should see their doctor, or even better, an allergist."

Antihistamines aren't a cure-all

Bender says many people take over-the-counter antihistamines before bed, but that can contribute to poor sleep. "It may make you sleepy initially, but you'll often wake up four hours later when it wears off."

He says people do not realize that prescription nasal steroids can significantly reduce nasal congestion, and he recommends non-pharmaceutical nasal saline rinses as well.

"Since I began using a nasal rinse a few years ago, it has helped," Stockmaster says. But she still struggles to breathe many nights, and she wakes her husband, Bob, with her tossing and turning.

Says Bender: "The better controlled the allergic rhinitis, the better the sleep, the better an allergy patient feels."

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Lynn Stockmaster and her dog Logan sit in her Rochester, N.Y., home. She says she's "definitely less social" when affected by pet dander and other allergens.

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